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General NPI Number Information
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NPI Number | 1861446254
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Entity Type | Individual
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Provider Name | SHAMILA MAUIYYEDI M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 05/21/2024
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Provider Practice Location Address
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Address Line | 301 UNIVERSITY BLVD
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City | GALVESTON
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State | TX
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Zip | 77555-5302
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Country | US
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Telephone | 409-772-1011
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Fax | 409-772-5683
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Provider Business Mailing Address
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Address Line | 6431 FANNIN STREET MSB 2.136
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City | HOUSTON
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State | TX
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Zip | 77030-1501
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Country | US
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Telephone | 713-500-5301
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Fax | 713-500-0695
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | L5458
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | L5458
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License Number State | TX
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